Prevention: Reducing Your Risk of Breast Cancer

Do you know if you have a high risk(HI RESK) — More likely to develop breast cancer for breast cancer? Some women may already know if they are, while others might not. Understanding your risk is very important so you can take action to prevent breast cancer from ever forming.

So—how fertile is your garden?
tree

Having a high risk(HI RESK) — More likely to develop breast cancer for breast cancer is like having an extremely fertile garden where both normal flowers and weeds (like the dandelion) are easy to grow. Luckily, just like gardeners know of some ways to try and prevent dandelions from growing in their flowerbeds, doctors also have ways to try and prevent breast cancer in patients who are at high risk(HI RESK) — More likely to develop breast cancer. The goal of prevention is to reduce a woman's risk of breast cancer before it has even started. The three most common ways doctors can prevent breast cancer are through a healthy lifestyle, medication, and surgery(SIR-JER-REE) — Physical removal of a tumor.

Healthy Lifestyle

Everyone knows they’re supposed to eat healthily. Your doctor always tells you, and your family probably does too. But we bet you didn't know that a healthy lifestyle is one of the easiest (and best) ways to prevent breast cancer. Doing things like eating right, exercising regularly, and avoiding tobacco and excess alcohol can go a long way in preventing breast cancer.1

Medication

In the garden, if you know there is a high chance for many dandelions to grow, you can use herbicides to prevent it. Herbicides are chemicals that you can apply to your garden in the fall and spring to block the growth of weeds. Likewise, doctors use medications (not herbicides) to try to prevent the growth of breast cancer cells. But instead of only taking these twice a year, you need to take them continuously for years to reduce the risk of cancer.

Tamoxifen(TAM-OX-EH-FIN) — An anti-hormonal medication that blocks estrogen and progesterone receptors; SERM; generic name for Nolvadex®, raloxifene(RAL-OX-EH-FEEN) — An anti-hormonal medication that blocks estrogen and progesterone receptors; SERM; generic name for Evista®, anastrozole(AN-AS-TRA-ZOL) — A medication that blocks the production of estrogen and progesterone; aromatase inhibitor; generic name for Arimidex®, and exemestane(EX-AH-MESS-TANE) — A medication that blocks the production of estrogen and progesterone; aromatase inhibitor; generic name for Aromasin® are examples of medications that doctors use. These types of medications block the effects of estrogen(ES-TRO-JIN) — A hormone or chemical that is needed for normal bodily functions in women but can also make some breast cancers grow on some breast cancer cells.

Surgery

A surgery(SIR-JER-REE) — Physical removal of a tumor called a prophylactic bilateral mastectomy(PRO-FIL-ACK-TIK BY-LAT-ER-ALL MAS-TEC-TOE-ME) — Removal of both breasts to prevent the development of breast cancer in the future might be recommended as a prevention strategy.

Those are some fancy doctor words. Let’s break them down to understand what this surgery(SIR-JER-REE) — Physical removal of a tumor is.

Prophylactic(PRO-FIL-ACK-TIK) — A technique or treatment used to prevent a condition before it starts is an action done to prevent something in the future.
An action to prevent a weed from growing.

Bilateral(BYE-LAT-ER-ALL) — Both breasts or sides of the body; right and left refers to both sides of something (in this case both breasts).
Both the right and left sides of a garden.

Mastectomy(MAS-TEC-TOE-ME) — The surgical removal of all breast tissue and some axillary lymph nodes is the removal of almost all the tissue(TISH-YOU) — The accumulation of cells that make up parts of the body, like organs in the breast.
Removing the entire flowerbed.

flowerpots

So, altogether a prophylactic bilateral mastectomy(PRO-FIL-ACK-TIK BY-LAT-ER-ALL MAS-TEC-TOE-ME) — Removal of both breasts to prevent the development of breast cancer in the future is the removal of almost all the tissue(TISH-YOU) — The accumulation of cells that make up parts of the body, like organs in both breasts to prevent future breast cancer. And just like removing the flowerbed, if both breasts are preventively removed, the risk of developing breast cancer significantly decreases.

Wondering why it works?

Well, in dandelion terms, a prophylactic bilateral mastectomy(PRO-FIL-ACK-TIK BY-LAT-ER-ALL MAS-TEC-TOE-ME) — Removal of both breasts to prevent the development of breast cancer in the future is like digging out your flowerbed and putting down a stone patio. The patio eliminates almost all of the fertile soil available for a dandelion to take root. Now, the only place the dandelions can grow is in between the cracks of the patio. This area is much smaller, significantly reducing the chance of a dandelion growing.

Which One Is for Me?

Everyone can try to prevent breast cancer by eating right, exercising regularly, and avoiding tobacco and excess alcohol. Why not try? Plus, these actions can help you live a longer, happier life!

Beyond a healthy lifestyle, when deciding between surgery(SIR-JER-REE) — Physical removal of a tumor, medication, and no treatment(TREET-MINT) — Techniques to help eliminate or control a disease, a woman must consider how aggressive she wants to be in trying to prevent breast cancer and when is the best time to take action.

A prophylactic bilateral mastectomy(PRO-FIL-ACK-TIK BY-LAT-ER-ALL MAS-TEC-TOE-ME) — Removal of both breasts to prevent the development of breast cancer in the future, although more invasive(IN-VAY-ZIV) — Something that penetrates or enters, reduces the risk of developing breast cancer by up to 90%.2,3 It is typically recommended for patients with BRCA1 or BRCA2 gene mutationsAbnormal or mutated breast cancer geneS that are passed down from parent to child and is associated with an increased chance of developing breast cancer and other cancers. This is because they have the most to gain from the surgery(SIR-JER-REE) — Physical removal of a tumor by reducing the risk of breast cancer (as they are at the highest risk).

gardening tools

Medication is usually chosen when a woman has above average (increased) risk of breast cancer, but the risk is not as extreme as it is with BRCA gene mutations(BRAK-AH JEAN MU-TAY-SHUNS) — Abnormal or mutated breast cancer genes that are passed down from parent to child and is associated with an increased chance of developing breast cancer and other cancers (85% chance of developing breast cancer in their lifetime). Doctors use risk calculators like the Gail Model (or other similar tests) to assess the risk of developing breast cancer.

The choice between medications depends on many factors, such as age, menopausal status (are you in menopause(MEN-A-PAUSE) — When estrogen levels fall and ovarian function is lost, leading to symptoms including hot flashes, mood changes, osteoporosis, and lack of menstrual periods or not), and if you are prone to develop osteoporosis(AH-STEA-O-POOR-O-SIS) — The weakening of the bones. Additionally, you will need to talk with your doctor about when it is best for you to start these medications. This decision is made by looking at many factors and weighing the risks and benefits.1

Deciding which prevention option (if any) is right for you can be very difficult. Be sure to discuss with your doctor the side effects of each prevention option and what exactly the surgery(SIR-JER-REE) — Physical removal of a tumor entails. These factors can affect your decision.

We know there is a lot to consider! Thankfully a cancer specialist can help guide you through all these decisions.
References
  1. Breast Cancer Prevention: Current Approaches and Future … http://www.eurjbreasthealth.com/sayilar/54/buyuk/64-711.pdf. Accessed December 20, 2018.
  2. Domchek SM, Friebel TM, Singer CF, et al. Association of risk-reducing surgery in BRCA1 or BRCA2 mutation carriers with cancer risk and mortality. JAMA. 2010;304(9):967–975. doi:10.1001/jama.2010.1237.
  3. Domchek SM, Friebel TM, Singer CF, et al. Association of risk-reducing surgery in BRCA1 or BRCA2 mutation carriers with cancer risk and mortality. JAMA. 2010;304(9):967–975. doi:10.1001/jama.2010.1237.
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